Budning Eye Institute

                         Specializing in Pediatric Ophthalmology and Adult and Pediatric Strabismus

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Treatment for Squint


After my strabismus surgery how long will my eye be red? Over the first 2 weeks post surgery most of the redness will clear. There will be some remaining redness over the area of the sutures until they are fully dissolved. This will take 6-12 weeks to occur.

Does eye surgery ever cause nausea? Post surgery there is a risk of nausea. This is best treated with gravol or similar medications.

 How will strabismus surgery affect my vision? Typically strabismus surgery itself does not affect the vision of each eye individually. This surgery will help to better align your eyes.

Children with straighter eyes will be provided with the opportunity to learn how to  use their eyes better together

Adults with straighter eyes may recover a past ability to use their eyes together.

The recovery or learning to use both eyes together remains difficult to quantify. We do know however that the best results are achieved by aligning the eyes at as young an age as possible.

In addition eye alignment when the eyes are deviated inwards will enlarge the visual field to a more normal range.

I see a little bump on the surface of my eye after surgery what is it and will it go away?  During the surgery one major stitch (suture) was placed to hold each muscle that was moved. These sutures will dissolve over a 6-8 week period of time. Until they have dissolved a bump will be visible. This bump may be reddish in colour. Time alone is required to allow the sutures to dissolve and the surface to heal completely.

Were stitches used during my strabismus surgery?  Yes. During the surgery one major stitch (suture) was placed to hold each muscle that was moved. These sutures will dissolve over a 6-8 week period of time. There were also some sutures placed on the surface layer of the eye (conjunctiva). These were placed to help keep all tissues in the best possible position for healing to provide the best post operative appearance.

What is the black or purple dot on my eye after strabismus surgery? These dots are the sutures placed at the time of surgery. They will dissolve or fall out over 2-12 weeks post surgery.

What should I avoid after strabismus surgery? It is most important to keep the eyes clean for 2-4 weeks post strabismus surgery. This will allow for proper healing and help to prevent infection.

We suggest staying out of dirty areas such as swimming pools for a minimum of 2 weeks following surgery. Goggles can then be used for an additional 2 weeks

You may go for a walk or resume most regular activities within a few days of surgery, but avoid very heavy lifting or vigorous activities

For runners, take it easy the first week with brisk walks, go at 50-60% or usual running the second week and then return to normal the third week

What type of pain killers are needed after strabismus surgery? On the day of surgery you will be given pain killers at the hospital. After going home most people feel that Acetaminophen (Atasol, Tylenol etc.) is usually sufficient. A cold cloth or even an ice pack used a few minutes on then a few minutes off helps to maintain comfort for a few days after surgery. It is best to avoid ASA or aspirin type preparations as they can lead to further bleeding.

When can I return to work or school after strabismus surgery? Typically after strabismus surgery students should stay home for 4-7 days. They may then return to school but must stay out of swimming pools, and dirty places, adn off Gym for an additional 2-3 weeks. They may then resume all activities. ADULTS: must similarly keep the eye area clean for 2-3 weeks. Thus the patients return to work depends on the type of work they perform. If you wish to do paper work, reading or anything clean you may return to it as soon as you feel well enough. Typically this is 3-14 days. For extremely dirty environments 3-4 weeks off work is suggested.

When should I be concerned about discharge? If there is a very greenish discharge, especially if associated with a big change in vision, significant worsening of pain, or redness you should call the office and be rechecked as soon as possible.

When can I expect my eyes to reach their best position after strabismus surgery? Often we can get a good idea of the eye position within 1 month of surgery. Healing does continue and the eye position may continue to shift for a year (or in some cases) more after surgery.

Will I require additional surgery for my strabismus? Eye movements are initiated in the eye movement centers of the brain, then travel along nerves to the eye muscles. When any part of the system is not working correctly strabismus occurs. As you can imagine this is an extremely complex system. Prior to your surgery we measure the eye deviation, and using that along with your medical history we will determine the best treatment. In most cases we are quite accurate and get the eyes 80-90% straighter. At times when we are not as accurate as we wish, and we over or under correct the eye position, we may end up with a residual strabismus. We then continue as we do with all cases after surgery by following and measuring your eye deviation. If we find that the deviation remains significant and we feel after discussing this together that we have a high chance to improve the eye position further we may consider further surgery. In all cases we will discuss in detail the risks and benefits of surgery with you prior to your surgery. We will work as a team and want you to play an active role in your or your Childs care.

Will there be bleeding after my strabismus surgery? Often there will be some bleeding the day of surgery. Occasionally (especially in complex and re-operative cases) the bleeding may continue for a few days after surgery. This is not dangerous and will clear with time. You may also expect some yellow mucous discharge due to the irritation from the sutures. This may continue for 3-5 days post surgery. Just take a cloth, gauze, or cotton ball with some warm water to clear it away.


Botulinum Toxin Treatment for Squint

What is the effect of botulinum toxin? The effect of botulinum toxin is to cause a paralysis of the muscle into which it has been injected.

 How long has it been in use?  Botulinum toxin was introduced for the treatment of Squint in 1979

 Will it affect my general heath? The treatment is perfectly safe and there is no risk to general health. In particular, there is no risk of developing botulism or food poisoning. There is no known risk when the treatment is given to women who are pregnant or breastfeeding, but some patients prefer to postpone treatment until this is over.

Who will I see when If attend the clinic? To begin with, you will have an examination by an orthoptist. Then you will see the consultant ophthalmologist (Dr. Budning). If the treatment is suitable for you, all risks and benefits will be reviewed with you and an appointment for Botulinum toxin injection will be arranged.

What is the procedure for the treatment? You will be given local anesthetic drops to numb the eye. These drops are very effective in taking away the surface sensation of the eye, but you should note that there will still be some discomfort as the injection is given, especially if you have scar tissue around the muscle from previous surgery. You will then have some wires attached to your forehead. These will be attached to an amplifier and loudspeaker, to allow the injection to be given exactly into the muscle, by monitoring the electrical activity of the muscle. You will hear this through the loudspeaker during the injection.

What happens when I have had the injection? You will be asked whether you prefer a pad on the eye, or to wear your own glasses. The eye is numb after the drops, and should be protected for about 2 hours in case something blows into the eye without your knowledge. You may feel an ache in the eye after injection. If that is not better in an hour, take whatever medication you would usually take for a headache.

When should I expect to see an effect from the treatment? The effect is usually noticed about 2 days after the injection is given.

How long does the effect last? This varies a lot, but it usually lasts for weeks, occasionally months, but then will wear off. To begin with, you may notice a temporary reversal of the squint, followed by gradual straightening of the eyes as the paralysis wears off.

What are the possible side-effects? Temporary reversal of the direction of the squint. Temporary double vision. If this is significant and bothersome you should not drive unless you cover one eye. Temporary drooping of the eyelid on the injected side (for up to 3-4 weeks). This typically resolves after a few weeks. Slight bruising on the surface of the eye or within the eyelid may occur. All these will get better without further treatment.

When do I return to the clinic? We like to see all our new patients one or two weeks after the injection. If the first injection did not produce an adequate effect, we may offer a repeat injection at that visit.

Other important information.     If you have any reason to believe that you may be a carrier of hepatitis or HIV virus, please make sure that you tell the doctor who sees you in the clinic. The information is confidential, but it is essential that we are informed.

We dispose of all injection needles after one use, so there is no risk of cross-contamination or infection.

 If you are not clear about any aspect of this treatment, please ask the doctor for an additional explanation.






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